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Form Q
Form Q
19
(F 2 S., T. & E) 1/59
[Regulation 62]
THE EMPLOYEES’ PROVIDENT FUND ACT No. 15 of 1958
Form “Q”
Membership Name of Employee Month and year in Amount due Amount Excess Amount Remarks For office use
Number respect of which Remitted remitted in only
recovery was made error
in error
Rs. cts. Rs. cts. Rs. cts.
TOTAL
………………………………………………...
Date : ……………………………………………… Signature of Employer